Trunk control, the ability to maintain and move the torso, is fundamental for nearly every type of mobility, including sitting, standing, and walking. Without stable control of the muscles surrounding the abdomen and back, coordinated movement of the limbs becomes significantly more difficult. The Trunk Control Test (TCT) is a standard, four-item assessment used by clinicians in rehabilitation settings to objectively measure a person’s motor control of the torso. The TCT provides a measurable value of motor impairment and is highly associated with a patient’s overall functional recovery trajectory.
The Purpose of the Trunk Control Test
The primary function of the TCT is to quantify motor impairment in the torso by measuring the individual’s ability to move and stabilize the trunk independently of their arms and legs. Clinicians rely on this tool due to its high degree of reliability, meaning the results are consistent across different testers and times. The assessment focuses purely on axial control, which is the foundational strength and coordination needed for postural adjustments.
Assessing the trunk separately allows therapists to isolate core deficits that might otherwise be masked by compensatory movements of the arms or legs. This isolation is useful for establishing a baseline for motor function early in the rehabilitation process. Since the test involves only four components and requires minimal equipment, it can typically be administered in less than five minutes, making it a practical and efficient screening tool. The score derived from the TCT is used to monitor progress over time and to predict a patient’s potential for regaining functional abilities.
Executing the Four Assessment Components
The TCT consists of four distinct movements, each performed while the patient is lying on a firm surface, such as a bed or treatment table. The first two components assess dynamic rolling ability, a foundational skill for bed mobility. The patient is asked to roll from a supine position (lying on the back) to their side, first toward the affected or weaker side, and then toward the stronger side.
The third component measures static balance, requiring the patient to sit on the edge of the bed with their feet unsupported for at least 30 seconds without using their hands. The final component evaluates the dynamic movement of sitting up from a lying position, which involves the coordinated strength of the abdominal and hip flexor muscles. The examiner observes the quality of movement and the level of assistance required for each task.
Each task is scored based on the level of performance, categorized into three levels. A score of 0 is recorded if the patient is completely unable to perform the movement without physical assistance or if they fall. A score of 1 indicates partial performance, meaning the patient completes the task but uses compensatory strategies, such as pulling on bed sheets or using their arms. The highest score, 2, is awarded only if the patient completes the task normally and independently.
Interpreting Results and Clinical Relevance
The final TCT score is calculated by summing the points awarded for each of the four components. The original, most-cited version of the TCT uses a scoring system resulting in a maximum possible score of 100. However, some simplified clinical versions, often used for specific neurological populations, utilize a maximum score of 24. Regardless of the scale used, a higher cumulative score indicates superior trunk control and a better prognosis for recovery.
The total score is highly predictive of a patient’s long-term functional independence, especially their ability to walk and manage daily activities. For instance, on the original 0-100 scale, a score of 50 or greater achieved within the first few weeks following a neurological event strongly predicts the recovery of independent walking ability within a few months. Conversely, a score in the lowest range suggests a lower chance of recovering walking function and a greater need for assistive devices or long-term care.
Clinicians use these results to set specific, measurable goals during rehabilitation. A low score immediately focuses physical therapy interventions on intensive trunk stability and dynamic balance exercises. The TCT score also informs discharge planning, helping the medical team determine the predicted level of support the patient will require at home, such as the need for a wheelchair, a walker, or assistance with transfers and self-care activities. The test provides an objective metric linking isolated motor ability directly to expected real-world function.